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Fast Facts: Perio Edition - AAP 2017 Classification System - Stage II Periodontitis
Fast Facts: Perio Edition Episode 49
[Andrew Johnston, RDH]
Welcome back everyone! You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
[Katrina Sanders, RDH]
Hello, and welcome to Fast Facts: Perio Edition and we're back. You guessed it to continue the conversation about AAP staging. Last week we looked at stage one periodontitis and how we classify patients that are standing on that border land between gingivitis and periodontitis. This week we talk about stage two periodontitis, and I want to be very clear when we talk about stage two periodontitis for our patients, we're specifically talking about patients who have likely been residing in a stage one periodontitis situation and have now experienced, as the Academy calls it "established periodontitis".
Specifically, our Academy indicates that a carefully performed clinical periodontal exam will identify the characteristics that this periodontitis has caused in damage at this stage in the disease process. This clinical periodontal exam will show us a few things.
Number one maximum probing depth anywhere in the mouth will be 5 mm. And again, I want to be clear. This 5mm is a true 5mm pocket, meaning we do forgive anywhere between 1mm to 3 mm of a relatively healthy and subsequently cleansable sulcus. The idea being that if this is a 5mm pocket not due to hyperplasia, tissue overgrowth or fibrosis, but actually due to apical migration of the junctional epithelium, the clinician will observe anywhere between 3mm to 4mm of interdental clinical attachment loss.
Aside from probing depth and I want to be very clear, yes, our clinical assessment can absolutely help with some of this. However, we may also see radiologic bone loss. This will be anywhere between 15-33% meaning the coronal third of the root will experience or be involved in a radiologic bone loss experience. If there is any radiologic bone loss, the Academy indicates that the patient will be presenting with mostly horizontal bone loss, and this particular patient has also not lost any teeth due to the periodontal disease process.
Now, patients that are in a stage two periodontitis situation, the Academy specifically states that at this stage, management does remain relatively simple for many cases because we can apply standard treatment principles like regular professional and personal bacterial removal and subsequent monitoring in order to arrest the progression of the disease process. Therefore, the Academy States that patients that are in stage 2 periodontitis have an opportunity for clear intervention and subsequent monitoring. However, the Academy also advises that careful evaluation of our stage 2 patients response to standard treatment is essential, and of course, we watch for grading, which we're going to take a look at in a moment that may help identify the patient's response or lack thereof, which may guide us to move the patient into more intensive management if needed.
Stay tuned as next week, we unpack stage three periodontitis.
This has been another episode of Fast Facts - Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website www.KatrinaSanders.com Cheers.
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts - Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at www.dentistrx.com. We'll see you next week for another Fast Fact!